Homeowner sues insurance company over alleged deceptive practices

FORT MYERS, Fla. – A man is suing his home insurance company because he says they were deceptive and uncooperative.

Bert Rivero had a refrigerator line bust June 2, so he called his insurance company, People’s Trust Insurance, to file a claim. Rivero said People’s Trust sent a company called Rapid Response to clean up all the water. Then his insurance company sent out an adjuster to asses the damage.

In Bert Rivero and many other homeowners’ cases, his insurance policy contains a practice called “managed repair” or “right to repair.” That clause means your insurance company will use its preferred contractor to repair your home, instead of giving you a check to find and pay a contractor of your choice. In Rivero’s case that means he gets a $75 discount every year on his insurance. But Rivero said after his experience, the discount was not worth the nightmare.

“He [the adjuster] comes over, he examines, he takes some readings but only readings in specific places,” Rivero said. “He tried to get me to sign a work authorization form, and I read through the initial page and it said you’re agreeing to the attached scope. Well, there was no attached scope. So I told him, I’m not going to sign this.”

Rivero said from that point forward, he questioned the motive of the insurance company adjuster and People’s Trust Insurance.

“The motive was to deceive, especially trying to get me to sign a blank work authorization form and have my signature on there and then later attach something to it. Right away I detected deceitfulness on their part,” Rivero said.

Rivero said the adjuster left that day, but returned days later and again asked, “‘Can you sign this work authorization form?’ Again, same blank form. It did not have any scope attached to it. But this was even worse, he had not even contacted my public adjuster. And that was on purpose.”

Four months later, Rivero has received a scope but says due to the way the situation was handled from the beginning he does not want to work with People’s Trust Insurance. He has now filed a lawsuit against People’s Trust Insurance, asking they give him the money so he can find his own contractor. People’s Trust filed a counter-suit.

PATTERN OF PRACTICE

Rivero’s situation is not the first time WINK News has heard from homeowners who said they did not know they had a managed repair clause in their insurance policy and the claim experience was horrible. In June, we interviewed two separate homeowners, who complained the managed repair process was a nightmare and their home was left in disarray for months. In one case, the homeowner who has People’s Trust Insurance is still fighting with the insurance company. In the second case the homeowner, who has Tower Hill Insurance, was able to settle and get money to make the appropriate repairs.

LAWMAKERS RESPONSE

We reached out to senators and representatives on the Insurance and Banking committee and sub-committee.

Senator Lizbeth Benacquisto told us her office was working with the Office of Insurance Regulation to see if there have been complaints filed across the state about this issue and what they can do to regulate the insurance companies.

When asked if an insurance company’s adjuster is allowed to ask a homeowner to sign a work authorization form without a scope, Sen. Benacquisto responded: “That’s inappropriate. If that person is going to sign away that they acknowledge this work is going to be done, there should be a stipulation as to what exactly is going to be done and how much it cost and the type of materials that are used in the process, so that they homeowner knows that their property is being returned to the condition it should be.”

When asked if that practice was illegal, Sen. Benacquisto said this: “We’re checking right now to make sure. Each contract is different so we want to be sure that we speak to the actual contract and that policy that he had on his home. But it is a policy holder’s right and the insurance company’s obligation to honor the policies that they take payments for.”

Sen. Benacquisto said if a homeowner is having problems, they should contact her office. Homeowners can reach her at 239-338-2570 or benacquisto.lizbeth.web@flsenate.gov. She also said they may be able to address the issue of homeowners not knowing this policy even existed until it was time to file a claim. She gave an example of how the legislature can help you.

“In many cases, Citizens would be one example, we mandated that insurance companies had to use certain type of font and certain sized font so they would be very clear of those notifications. That might be something we can look at if this is,” she explained.

We also spoke with Sen. Tom Lee and Rep. Kathleen Passidomo, who said they will look at this during the legislative session.

WHY MANAGED REPAIR

In previous reporting, a spokesperson for the Insurance Information Institute defended this practice, saying it has cut down on fraud.

“There has been a lot of abuse of these water damage claims specifically. What happens is there’s something called assignment of benefits, where a policy holder gives up the right to control that claim. They give it up to a contractor and that contractor may bring in other professionals to do the repair work and that inflates the cost of the claim. The insurance company doesn’t get a chance to inspect the damage before it’s repaired and so the costs sky rocket, and we all pay for that,” said Lynne McChristian with the Insurance Information Institute.

PEOPLE’S TRUST INSURANCE COMPANY RESPONSE

Michelle Ubben, a spokesperson for People’s Trust Insurance sent a response to the Rivero family’s claims. Below is part of that statement.

“Mr. Rivero agreed to the People’s Trust direct repair program when he purchased his homeowner’s insurance policy and received a premium discount in consideration. By refusing to let repairs proceed, Mr. Rivero is actually in breach of his contract. The work authorization is merely an acknowledgment by the homeowner that the company is permitted to be on the property to assess the damage and make preparations for repairs. It does not obligate the homeowner to accept a specific scope of work.”

We asked People’s Trust Insurance to further elaborate on the last two sentences because the form does read, “I understand and agree that the work which is to be done by RRT is set forth in the attached scope of repairs, and that the attached scope of repairs is sufficient to place my home back in its pre-loss condition, as required by the policy.”

Ubben wrote back, “The facts in this case are in dispute and are the subject of litigation. For that reason, we aren’t going to engage in debating the facts of this case with the media.”